a Department of Nephrology , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
b Department of Ultrasound , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
Int J Hyperthermia. 2017 Dec;33(8):946-952. doi: 10.1080/02656736.2017.1357210. Epub 2017 Aug 2.
Microwave ablation (MWA) is an effective treatment for severe secondary hyperparathyroidism (SHPT), but it can also be used for mild-to-moderate secondary hyperparathyroidism (SHPT). In this randomised, controlled study, the efficacy of MWA in the treatment of mild-to-moderate hyperparathyroidism is investigated.
We assessed outcomes 12 months after the randomisation of 28 patients with mild-to-moderate SHPT. The subjects received either MWA plus calcitriol or calcitriol alone. The primary end-points were the rate of achieving target levels of intact parathyroid hormone (iPTH), changes in iPTH levels and the rate of patients developing severe SHPT.
Primary end points: the overall rates of achieving target levels of iPTH were comparable between the MWA and calcitriol alone groups (24% vs. 22%, p = 0.85). However, the rate of iPTH <150 pg/mL (lower limit of the target range) in the MWA group was higher than that in the calcitriol alone group (23% vs. 8%, p = 0.02). The mean iPTH level in the MWA group after MWA was lower than that in the calcitriol alone group (373.09 ± 322.31 vs. 552.28 ± 361.87 pg/mL, p < 0.001). There was a significant difference in the change in iPTH levels over time within the MWA group (p < 0.001) but not in the calcitriol alone group. Only one patient developed severe SHPT in the MWA group, while six patients in the calcitriol alone group developed severe SHPT (p = 0.04).
Compared with calcitriol alone, MWA plus calcitriol decreases iPTH levels and prevents the progression of mild-to-moderate SHPT.
微波消融（MWA）是治疗严重继发性甲状旁腺功能亢进症（SHPT）的有效方法，但也可用于治疗轻度至中度继发性甲状旁腺功能亢进症（SHPT）。在这项随机对照研究中，研究了 MWA 治疗轻度至中度甲状旁腺功能亢进症的疗效。
我们评估了 28 例轻度至中度 SHPT 患者随机分组后 12 个月的结局。这些患者分别接受 MWA 联合骨化三醇或单纯骨化三醇治疗。主要终点是达到完整甲状旁腺激素（iPTH）目标水平的比例、iPTH 水平的变化以及发生严重 SHPT 的患者比例。
主要终点：MWA 组和单纯骨化三醇组达到 iPTH 目标水平的总体比例相当（24%比 22%，p=0.85）。然而，MWA 组 iPTH<150pg/mL（目标范围下限）的比例高于单纯骨化三醇组（23%比 8%，p=0.02）。MWA 组 MWA 治疗后 iPTH 平均水平低于单纯骨化三醇组（373.09±322.31比 552.28±361.87pg/mL，p<0.001）。MWA 组 iPTH 水平随时间的变化有显著差异（p<0.001），而单纯骨化三醇组无显著差异。MWA 组仅 1 例发生严重 SHPT，单纯骨化三醇组 6 例发生严重 SHPT（p=0.04）。
与单纯骨化三醇相比，MWA 联合骨化三醇可降低 iPTH 水平，预防轻度至中度 SHPT 的进展。
